目的 分析信阳市发热伴血小板减少综合征患者二次感染新型布尼亚病毒(Severe fever with thrombocytopenia syndrome virus,SFTSV)的发病特点。方法 收集同一患者不同时间发病资料,并对资料进行描述性分析。结果 两次新型布尼亚病毒核酸检测均为阳性,该患者第1次发病,发热持续时间长、临床病情重、病毒载量高、病程长;第2次发病,热程短、自觉症状轻、病毒载量低、恢复快,表明机体对SFTSV已有一定免疫,但再次感染时血清ALT、AST、LDH、CK较第1次明显升高。结论 新型布尼亚病毒重复感染使机体产生免疫的同时有变态反应的参与,极其类似郭霍现象(Koch phenomenon);该患者两次感染时间间隔不到2年的时间,提示SFTSV发生变异或存在多个血清型可能,或者SFTSV感染后无法获得持久的免疫力。
Abstract
Objective To analyze the characteristics of secondary infection with newbunyavirus in patients with fever and thrombocytopenia syndrome in Xinyang City. Methods The data of the same patient at different time were collected and analyzed.Result Two new bunyavirus nucleic acid tests were positive.The first onset of the patient had a long fever duration,severe clinical condition,high viral load and long course of disease;while the second onset of the patient had a short fever course,mild symptoms,low viral load and rapid recovery,indicating that the body had certain immunity to SFTSV;but the serum ALT,AST,LDH and CK were significantly higher than those of the first onset. Conclusion The repeated infection of the new bunyavirus causes the body to produce immunity with the participation of allergy,which is very similar to Koch phenomenon.The time interval between the two infections of the patient is less than 2 years,which indicates that the SFTSV may have mutation or multiple serotypes,or the SFTSV infection can not obtain lasting immunity.
关键词
新型布尼亚病毒 /
重复感染 /
临床特点 /
新发传染病
Key words
newbunyavirus /
repeated infection /
clinical characteristics /
emerging infectious diseases
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Yu XJ,Liang MF,Zhang SY,et al.Development and validation of a real‐time reverse transcriptase PCR assay for sensitive detection of SFTSV[J].Journal of Medical Virology,2017,89(7):1131-1138.
[2] Baek YH,Cheon HS,Park SJ,et al.Simple,rapid and sensitive portable molecular diagnosis of SFTS virus using Reverse Transcriptional Loop-Mediated Isothermal Amplification (RT-LAMP)[J].Journal of microbiology and biotechnology,2018,28(11):1928-1936.
[3] 中华人民共和国卫生部.发热伴血小板减少综合征防治指南(2010版)[M].中华临床感染病杂志,2011(4):193-194.
[4] Yu XJ,Liang MF,Zhang SY,et al.Fever with thrombocytopenia associated with a novelbunyavirus in China[J].New England Journal of Medicine,2011,364:1523-1532.
[5] 王宇明.感染病学[M].第2版.北京:人民卫生出版社,2010:325-327.
[6] 李兰娟.感染病学临床诊治2016年度新进展[J].浙江医学,2017,39(8):597-598,605.
[7] Ding NZ,Luo ZF,Niu DD,et al.Identification of two severe fever with thrombocytopenia syndrome virus strains originating from reassortment[J].Virus Res,2013,178(2):543-546.
[8] He CQ,Ding NZ.Discovery of severe fever with thrombocytopenia syndrome bunyavirus strains originating from intragenic recombination[J].JVirol,2012,86(22):12426-12430.
[9] 方欣玉,张楠,李志峰,等.发热伴血小板减少综合征血清SFTSV中和抗体消长及影响因素[J].国际病毒学杂志,2020,27(3):219-223.
[10] Rook GA,Stanford JL.The Koch phenomenon and the immunopathology of tuberculosis[J].Current topics in microbiology and immunology,1996,215.
[11] Shrivastava S,Shrivastava P.World Health Organization releases the list of blueprint priority diseases.2018,45(1):49-49.